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Cephalexin

Overview

Field Detail
Drug class 1st generation cephalosporin
Route Oral
Forms 250 mg, 500 mg tablets; 125 mg/5 mL, 250 mg/5 mL suspension
Storage Room temp before; refrigerate suspension after mixing

Preparation for Oral Challenge

Before you start

Ensure the patient has fasted if required. Use a calibrated oral syringe for all volumes. Check the concentration of the suspension (125 mg/5 mL or 250 mg/5 mL).

Reagents

  • Cephalexin Suspension (e.g., Keflex)
  • Syringes: 1 mL, 3 mL, 5 mL, 10 mL oral syringes

Step-by-step Challenge Protocol

Using 125 mg/5 mL (25 mg/mL) Suspension:

Step Dose Volume Cumulative Dose
1 25 mg 1.0 mL 25 mg
2 50 mg 2.0 mL 75 mg
3 100 mg 4.0 mL 175 mg
4 250 mg 10.0 mL 425 mg

Challenge Protocol

Intervals: Observe for 30–60 minutes between each step. Final Observation: Monitor for 1–2 hours after the final dose.


Notes

  • Cephalexin is the most common oral 1st generation cephalosporin.
  • Cross-reactivity with Amoxicillin and Ampicillin is common due to shared side chains.
  • Not routinely used for skin testing. If required, test with Cefazolin and Penicillins.